移植后肝细胞癌:平衡免疫抑制和免疫检查点抑制剂
Tomoharu Yamada1, Ryosuke Tateishi1, Mitsuhiro Fujishiro1
1Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Clinical and molecular hepatology
|February 2, 2026
概括
肝移植可以改善存活率,但也面临诸如HCC复发等挑战. 新的生物标志物和免疫疗法为移植接受者提供了更好的风险分层和长期结果的希望.
科学领域:
- 肝病学和移植外科手术
- 在瘤学瘤学.
- 免疫学 免疫学 免疫学
背景情况:
- 肝移植 (LT) 是对末期肝病和肝细胞癌 (HCC) 的关键治疗方法.
- 虽然LT后的早期存活率有所改善,但长期结果受到HCC复发,排斥和其他并发症的阻碍.
- 在LT后对HCC复发的准确风险分层仍然是一个重大的临床挑战.
研究的目的:
- 审查目前面临的挑战和管理肝细胞癌 (HCC) 肝移植 (LT) 后复发的新兴进展.
- 探索新生物标志物和免疫疗法的潜力,以改善LT接受者的结果.
主要方法:
- 关于LT后HCC复发的当前文献的审查.
- 分析系统疗法的进展,包括免疫检查点抑制剂 (ICI) 和氨酸激酶抑制剂.
- 探索新的生物标志物 (例如cfDNA,微生物组) 和免疫疗法 (例如瘤病毒,mRNA疫苗).
主要成果:
- HCC复发仍然是LT后的一个主要挑战,目前的预后模型的准确性有限.
- 与ICI一样,无法切除的HCC的全身疗法在移植环境中存在独特的挑战和风险 (例如,排斥).
- 新兴的生物标志物和创新的免疫疗法显示出改善风险分层和开发向治疗的前景.
结论:
- 尽管早期存活率有所改善,但对LT接受者的长期治疗需要解决HCC复发和其他并发症.
- 新型生物标志物和免疫疗法将对未来的LT患者管理产生重大影响,可能改善风险分层和治疗疗效.
- 在移植后环境中应用新型全身疗法时,仔细考虑风险和益处至关重要.
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